Predictive Factors for Response and Survival in a Cohort of Oligometastatic Patients Treated With Stereotactic Body Radiation Therapy

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Abstract

PURPOSE: This study evaluated patients, treatment, or disease characteristics that could predict response to stereotactic body radiation therapy (SBRT) and survival in a database of patients with oligometastatic disease from different solid tumors.

METHODS AND MATERIALS: Patients treated with SBRT for oligometastatic disease between 2014 and 2015 were included. Patients were defined as oligometastatic if they were affected by a maximum of 5 active lesions in 3 different sites. They had to be treated with SBRT with radical intent.

RESULTS: The study included 358 patients. With a median follow-up of 31.83 months, local control at 6 and 24 months was 94.6% and 78.9%, respectively. Distant progression was recorded in 279 patients (77.9%). Progression-free survival at 6 and 24 months was 66.1% and 18.4%, respectively. At last follow-up, 195 patients (54.5%) were still alive in 59 cases with no evidence of disease. The median overall survival (OS) was 34.7 months (95% confidence interval, 29.66-43.83). OS at 6 and 24 months was 96.07% and 63.57%, respectively. On multivariable analysis, the presence of lung metastases (hazard ratio [HR], 0.50 [0.33-0.75]; P = .001) and nodal metastases (HR, 0.44 [0.24-0.78]; P = .005) was related to longer OS. Primary lung cancer (HR, 1.89 [1.14-3.13]; P = .013), increasing age (HR, 1.02 [1.01-1.04]; P = .002), and the presence of metastatic sites other than the irradiated ones (HR, 2.19 [1.39-3.43]; P = .001) were all independent predictors of shorter OS. Local response was associated with OS.

CONCLUSIONS: SBRT for patients with oligometastatic disease is effective. Local response is strongly correlated with patients'' prognosis, also underlying its relevance in a metastatic setting.

Original languageEnglish
Pages (from-to)111-121
Number of pages11
JournalInternational Journal of Radiation Oncology Biology Physics
Volume104
Issue number1
DOIs
Publication statusPublished - May 1 2019

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Keywords

  • Adenocarcinoma/mortality
  • Aged
  • Confidence Intervals
  • Female
  • Humans
  • Lung Neoplasms
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Metastasis/pathology
  • Prognosis
  • Progression-Free Survival
  • Radiosurgery/methods
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

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